Delivery information systems and methods

ABSTRACT

Systems and methods support dental patient scheduling relating to one or more dental appliances by communicating manufacturing progress information with a patient computer over a wide area network; and performing patient scheduling when one or more dental appliances reach a predetermined manufacturing progress.

BACKGROUND

The Internet has become a significant medium for communication andcommerce and has enabled millions of people to share information andconduct business electronically. The unique characteristics of theInternet such as its ability to provide enhanced communication, richtext, and graphic environment provide an ideal support for a widevariety of electronic commerce transactions. For example, a consumer cansearch, review, and extensively shop a number of competing chains in aninstant. As such, consumers benefit by being able to obtain a good pricerelatively quickly and easily.

On-line retailers also benefit, since these retailers can carry a largernumber of products at a lower cost and with greater merchandisingflexibility without the physical constraints faced by traditionalretailers. Additionally, they can assist the consumer's purchasedecision by providing relevant information and enabling consumers toshop at their convenience by remaining open 24 hours a day, seven days aweek. Online retailers can also provide personalized services and usedirect marketing efforts based on information provided by customers.

As such, the Internet has evolved into a unique sales and marketingchannel. The ubiquity and convenience of the Internet makes it ideal fordispensing information on certain topics that traditionally requirevisits to specialists. For example, certain consumers may be interestedin products and services associated with orthodontics and dentofacialorthopedics that specializes in the diagnosis, prevention and treatmentof dental and facial irregularities (“malocclusion” or “bad bite”). Theorthodontic treatment process typically uses corrective appliances suchas braces and/or other fixed or removable appliances to bring the teeth,lips and jaws into proper alignment and to achieve a facial balance. Thepervasiveness of the Internet makes it an ideal source for informationrelating to these products and services.

SUMMARY

Systems and methods support dental patient scheduling relating to one ormore dental appliances by communicating manufacturing progressinformation with a patient computer over a wide area network; andperforming patient scheduling when one or more dental appliances reach apredetermined manufacturing progress.

In one aspect, a system supports dental patient scheduling with anetwork to communicate information relating to a manufacturing stage;one or more patient computers coupled to the network; and a servercoupled to the network, the server communicating manufacturing progressinformation with the patient computer and performing patient schedulingwhen one or more dental appliances reach a predetermined manufacturingprogress.

Implementations of the system may include one or more of the following.The server can send a message to a patient when the appliances reach apredetermined manufacturing stage. The message can be sent when theappliances are being marked. The server can send a message to a treatingprofessional when the appliances reach one or more intermediate stagesof manufacturing. The server can send an electronic mail message totransmit information relating to manufacturing progress. The server canmaintain calendar pages for the treating professionals. The server caninvite a patient to access an on-line calendar and schedule anappointment when the appliances reach the last stage of manufacturing. Anetwork of treating professionals can be accessed using the network. Theserver can request intervention from manufacturing personnel when one ormore manufacturing stages fall behind schedule and can update thepatient with information relating to a delay caused by manufacturingslippage.

Advantages of the system may include one or more of the following. Fortreating professionals and patients, the system provides a convenientway to communicate information, including scheduling information. Thesystem also enables people to share their schedules with the treatingprofessional. The system is convenient to use and provides informativetreatment experience through which dental care services anddental-related products can be dispensed. Consumers can access thesystem using an intuitive, easy-to-use interface that is available 24hours a day, seven days a week and from anywhere Internet access isavailable.

The system quickly reports to a user such as a treating professional ora patient the status of the manufacturing operations. If a particularmanufacturing operation is late or early, the user can adjust his or herschedule appropriately. This is done without requiring a person to callthe user and communicate the delivery date. The system allows theorthodontist and the patient sufficient lead-time to schedule anappointment.

The system also eliminates resources required to automatically informusers and manufacturing personnel of manufacturing status. Thisoperation is done cost-effectively without requiring human operators tokeep track of delivery information and to physically call users in casethe manufacturing of the appliances falls behind schedule

The system is also efficient to use for treating professionals such asorthodontists. An orthodontist can simply log-in to the system, open hisor her on-line calendar, pick up the patient's folder on the system andreview the status of the case. The treating professional reduces theprofessional's overhead in that patients directly schedule theappointment without having to coordinate availability with areceptionist.

Correspondingly, patients also experience higher quality of servicesince he or she can log-in, monitor the progress of the production ofhis or her appliances, and schedule appoints if necessary. Theseoperations can be done anywhere and at any time, as long as the patientsand the treating professionals have access to the Internet.

The system supports a virtual community of dental patients, dentists,specialists such as orthodontists and oral surgeons, financialinstitutions, benefit providers and the providers of dental equipment orservices. For treating professionals, such as dentists andorthodontists, the system provides a one-stop solution for planningpatient treatments, managing communication with patients, storingpatient records and sharing records with relevant persons outside thedoctor's office.

Aspects of the final treatment plan can be used to generate appliancesused in the physical treatment. The information associated with thepatient's treatment (visual images, virtual treatment plans, file notesand the like) are digitized and maintained in a central storage facilityin a secure manner. Doctors and patients can have access to these fileswithout the need to extract files and models from storage and withreduced risk of records being misplaced.

Administratively, the system allows the office to be managed moreefficiently without requiring the treating professional to purchase andmaintain special software. The system keeps track of all patients thatneed to be contacted for an appointment. Scheduling can be doneautomatically or can be customized to the office's preference andavailability of treating professionals and supporting resources. Basedon the appointments, the system can electronically mail (email) patientswith reminders. Alternatively, the system can print reminder cards thatcan be mailed to patients reminding them of their appointment. Thesystem can also automatically generate personalized correspondence topatients relating to data collected in the initial exam and treatmentrecommendations. Moreover, the patient can review the proposed treatmentwith the treating professional anywhere.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a diagram of an exemplary environment supporting electroniccommerce.

FIG. 2 is a diagram of a server to support scheduling operations.

FIG. 3 is a diagram of a web site on the server of FIG. 2.

FIG. 4 is a flowchart of a process to produce a dental appliance.

FIG. 5 shows a system for making the dental appliance.

FIG. 6A is a flowchart of a first process for scheduling dental relatedappointments.

FIG. 6A is a flowchart of a second process for scheduling dental relatedappointments.

FIG. 6B shows a second embodiment of a system for producing appliancesand scheduling appointments.

FIGS. 7A-7B are flowcharts of a process to generate treatment plans andto schedule appointments when appliances are ready for delivery.

FIG. 8 is a diagram illustrating a computer system to support thefabrication of appliances.

DESCRIPTION

Referring now to FIG. 1, an environment supporting a dental system 100is shown. The system 100 communicates over a network 102 that can be alocal area network or a wide area network such as the Internet.

One or more client computers 104-105 can be connected to the network102. In one embodiment where the network 102 is the Internet, the clientcomputers execute a suitable browser such as Navigator from Netscape,Inc. and Internet Explorer from Microsoft Corp. By clicking on thehighlighted text (or specific graphic image), the user can jump from thecurrent web page to a new web page address associated with the link—withthe new page displayed on the screen. In this manner, the user can “surfthe web” by clicking on an almost endless succession of links going topage after page all following a common thread as defined by the text orgraphic component of the link label.

Through the network 102, the client computers 104-105 can access adental server 106. The dental server 106 serves a web site, a portal, avertical portal (vortal), or a content site for providing dental relatedinformation to interested parties such as dental patients, dentists,orthodontists, and others. When sensitive information is communicatedthrough the dental server 106, such information is securely encryptedusing Secure Sockets Layer (SSL) technology throughout the transaction.The server 106 can be a stand-alone computer or can be a server farmthat can distribute processing and communications activity across acomputer network so that no single device is overwhelmed. During loadbalancing, if one server is swamped with requests, excess requests areforwarded to another server with more capacity.

The network 102 connects the dental server 106 to one or more treatingprofessional workstations 108-109. The workstations 108-109 allowtreating professionals access to a plethora of services provided by thedental server 106 such as patient treatment and office management, amongothers. The dental server 106 stores information associated with patienthistory on-line in a secure manner. The server 106 also allows thetreating professional to have a comprehensive view of the patient'streatment history at any time using a suitable browser, eliminating theneed to pull treatment files or charts or to look for misfiled or lostcharts. The dental server 106 also provides treating professionals withtools to analyze patient data, for example, tools to reconstruct a 3Dmodel of the teeth. For example, using the browser, the treatingprofessional can request the server 106 to animate the progress of thetreatment plan. When the treating professional arrives at a prescriptionor other final designation, the treatment prescription is used toautomatically generate appliances, as described in more details below.Further, in addition to aiding professionals in treating patients, thetreating professional can perform office management, purchasing andother logistical operations using the browser and the dental server 106.

In addition to communicating with patients and treating professionals,the dental server 106 can communicate with one or more partners 110using the network 102. The partners 110 can be product suppliers,service providers, or any suitable commercial entities.

One partner 110 can be a financing partner that offers customers withone or more electronic financing options. In one implementation, thefinancing partner can be a credit card processing company. The creditcard processing company can accept a customer's existing credit card orcan issue the customer with a new credit card. Further, the credit cardcan be issued under the name of a third-party bank, the name of thecredit card processing company, or the name of the site supported by thedental server 106 under a co-branding arrangement.

The customer enters the sensitive data such as credit card number,shipping address, among others, onto a purchase form. The credit data isthen submitted, collected and passed securely through the dental server106. This data can be processed in real time or can be collected by mailor telephone and then entered by an operator. A processor at the creditcard processing company then verifies that the credit card number isvalid and is not stolen, among other anti-fraud measures. If the creditcard information is valid, the purchase price will be reserved from theissuing bank of the consumer's credit card and allocated to the accountassociated with the server 106. Periodically, the credit card processorsettles all accounts; it is at this time that all monies move. Fundsreserved are transmitted from the issuing bank of the cardholder'scredit card to the account of the server 106. Also, discount fees arepaid from these funds, as they are moving.

Alternatively, the financing partner can debit from the customer'schecking account over the Internet. One such check debiting services isthe MerchanTrust™ Paperless Checks™ Services, available from MerchantCommerce, Inc. These services provide customers with the convenience ofmaking online purchases by checking account debits, with no manual dataentry required of a merchant. In this embodiment, a customer fills in aform at the site with bank information printed at the bottom of his orher personal check. The information is processed as an Electronic FundsTransfer (EFT) to the customer's account using the AutomatedClearinghouse (ACH) payment system.

Yet another possible partner 110 is a dental supply retailer providingan on-line shop on the web site to retail dental products to thecustomers and treating professionals. The retailer can be a co-brandingpartner that uses the brand name linked or suitably associated with theweb site of the server 106 such that users of the server 106 would notknow that the on-line shop is actually operated by a third party. Theretailer can offer dental products for brushing, flossing, and cleaningof dental implants and bridges. Other dental products includeanti-plaque rinse and plaque-fighting toothpaste. The retailer can alsosell other health-care-related products such as prescription drugs;non-prescription drugs; personal care; beauty and spa; vitamins, herbsand nutrition; and medical supplies. Additionally, the retailer canserve the needs of the treating professionals by offering products suchas brackets, buccal tubes, bands, archwire products, bonding adhesives,hand instruments, systems, supplies and equipment.

Yet another partner 110 can be a shipping partner. The shipping partnerdelivers dental supply or goods received from a multiplicity ofproducers and manufacturers for ultimate distribution to each customer.The facilities for warehousing and introduction of goods into atransportation stream for redistribution are the so-called cross dockingfacilities. The supply or good flows in bulk from a producer or amanufacturer to one or more cross docking facilities owned by either theshipping partner or the operator of the server 106. The items are thenbe broken into smaller unit sizes and distributed to the customers.

The above list of partners lists only exemplary partners and is not anexhaustive list. Other possible partners include value-added serviceproviders such as third party software providers who provide plug-inviewing and diagnostic enhancements that can be used by theprofessionals.

In addition to performing orthodontic operations, the server 106 canalso perform other value-added services. For example, processes executedby the server 106 can simulate the color of the patient's enamel andshow the color of the teeth before and after bleaching. Further,processes on the server 106 can simulate the color of the patient'ssilver fillings (amalgram) and show the teeth after cosmetic work tocover the amalgam. Once the patient has accepted a particular treatmentselection, the server 106 offers the patient with one or more financingoptions from one of its financial partners. Additionally, the server 106can guide the patient to an on-line shopping store to purchase productsrelating to his or her dental health. For example, the patient can buycleaning supplies, brushes, and flossing supply at a price competitiveto his or her traditional stores. Moreover, the products can bedelivered to the patient using one or more delivery partners at aconvenient time.

The server 106 can perform dynamic targeting and information gathering.The users provide demographic information when they register for ourservice. The server 106 can track our users' behavior the entire timethey are online. As a result, the server 106 can deliver targetedadvertisements and measure their effectiveness. For example, users canreceive ads from a brokerage firm when they are viewing sites containingstock quotes or financial news, or receive promotions from a booksellerwhen browsing sites containing book reviews. As such, the dental server106 can provide a prominent and sustained advertising medium to thecommunity. In contrast to most portal and content sites which displayadvertising, the site remains with users the entire time they areonline. Once users are logged on, the site remains in full viewthroughout the session, including when they are waiting for pages todownload, navigating the Internet and even engaging in non-browsingactivities such as sending or receiving e-mail. The constant visibilityof the site allows advertisements to be displayed for a specified periodof time.

In combination, the dental server 106 forms a hub that links dentalclients using client computers 104-105, treating professionals usingworkstations 108-109, and partners 110 into a living electronic commerce(e-commerce) community.

FIG. 2 shows an embodiment of the server 106. The server 106 includes aweb server 140, a patient information server 142, a resource planning(RP) server 144 and a streaming server 146. In one embodiment, the RPserver 144 runs Microsoft SQL server and provides information relatingto a doctor or a patient such as address and history. When a patient'scase or static snapshots of the case is needed, the data is pulled fromthe patient information server 142. When media data such as video needsto be streamed to a requesting client, the streaming server 146 can sendthe stream. In one implementation, the streaming data is stored inQuickTime format on a Linux-based server running the QuickTime serversoftware.

The servers can be clustered. In one embodiment using Microsoft'sCluster Server, cluster-enabled applications such as Microsoft's SQLServer and Exchange. With Cluster Server, two servers can runapplications at the same time. When one server fails, the remainingserver handles its application as well as the failed server'sapplications. Next, the remaining server adopts the IP address of thefailed server and mounts one or more data drives that the two systemsshare. The remaining server is rebooted and applications such as SQLServer can be started and initialized on this server. Persistent clientscan re-attach to the server and continue to operate.

Referring now to FIG. 3, a diagram 200 shows various major functionssupported by the dental server 106. First, the process 200 performs anautomatic detection for the existence of a browser welcome plug-in (step202). If the welcome plug-in exists, an introductory animation (flash)is shown (step 204). From step 204 or 206, the process 200 shows a homepage (step 206) with one or more links. A link is created by having aword in a text field (or a graphic image on a web page) linked to thelocation of another web page, via a string of information setting forththe new web page address presented in hypertext transfer protocol(HTTP), among others.

The user can navigate the home page to join a particular site from aconstellation of related sites. For instance, the user can navigate to apatient's site (step 208), a doctor's site (step 210), a privacystatement site (step 212), one or more additional sites (step 214), andan about site (step 216), among others. The additional sites can be anon-line shopping store that is co-branded with the web site hosted bythe server 106, or the on-line shopping store can be directly affiliatedwith a third party such as planet-rx.com, among others. The additionalsites can also be third party value-added providers of products and/orservices.

In one embodiment, during start-up, a browser checks for a viewerplug-in module in a “plugins” subdirectory (Windows) or Plug-ins folder(Mac OS) in the same folder or directory as the browser. If the viewerplug-in module is available, the browser looks for a MIME type andextension info from the version resource. Through a TYPE attribute, thebrowser knows the MIME type and can load a registered plug-in first and,if there are no matches for the MIME type, the browser looks for ahelper application. Once the viewer plug-in is identified, the browserloads the viewer plug-in code into memory; initializes the viewerplug-in; and creates a new instance of the viewer plug-in. When the userleaves the site or closes the window, the viewer plug-in instance isdeleted. When the last instance of the viewer plug-in is deleted, theplug-in code is unloaded from memory. Next, data files are downloaded tothe viewer plug-in. In one implementation, the viewer plug-in downloadsa data file from the dental server 102 using a suitable protocol such asa file transfer protocol (FTP). The viewer plug-in uses the downloadedfile to present the treatment plan graphically to the clinician. Theviewer plug-in also can be used by the treatment plan designer at thehost site to view images of a patient's teeth.

FIG. 4 shows a process 230 for producing the incremental positionadjustment appliances for subsequent use by a patient to reposition thepatient's teeth. As a first step, an initial digital data set (IDDS)representing an initial tooth arrangement is obtained (step 232). TheIDDS may be obtained in a variety of ways. For example, the patient'steeth may be scanned or imaged using X-rays, three dimensional X-rays,computer-aided tomographic images or data sets, or magnetic resonanceimages, among others. More details on the contact or non-contactscanners are in commonly-owned and co-pending application Ser. No.09/169,276, filed Oct. 8, 1998, the content of which is incorporated byreference.

A plaster cast of the patient's teeth is obtained by well knowntechniques, such as those described in Graber, Orthodontics: Principleand Practice, Second Edition, Saunders, Philadelphia, 1969, pp. 401-415.After the tooth casting is obtained, the casting is digitally scanned bya scanner, such as a non-contact type laser or destructive scanner or acontact-type scanner, to produce the IDDS. The data set produced by thescanner may be presented in any of a variety of digital formats toensure compatibility with the software used to manipulate imagesrepresented by the data. In addition to the 3D image data gathered bylaser scanning or destructive scanning the exposed surfaces of theteeth, a user may wish to gather data about hidden features, such as theroots of the patient's teeth and the patient's jaw bones. Thisinformation is used to build a detailed model of the patient's dentitionand to show with more accuracy and precision how the teeth will respondto treatment. For example, information about the roots allows modelingof all tooth surfaces, instead of just the crowns, which in turn allowssimulation of the relationships between the crowns and the roots as theymove during treatment. Information about the patient's jaws and gumsalso enables a more accurate model of tooth movement during treatment.For example, an x-ray of the patient's jaw bones can assist inidentifying ankylose teeth, and an MRI can provide information about thedensity of the patient's gum tissue. Moreover, information about therelationship between the patient's teeth and other cranial featuresallows accurate alignment of the teeth with respect to the rest of thehead at each of the treatment steps. Data about these hidden featuresmay be gathered from many sources, including 2D and 3D x-ray systems, CTscanners, and magnetic resonance imaging (MRI) systems. Using this datato introduce visually hidden features to the tooth model is described inmore detail below. The IDDS is manipulated using a computer having asuitable graphical user interface (GUI) and software appropriate forviewing and modifying the images. More specific aspects of this processwill be described in detail below.

Individual tooth and other components may be segmented or isolated inthe model to permit their individual repositioning or removal from thedigital model. After segmenting or isolating the components, the userwill often reposition the tooth in the model by following a prescriptionor other written specification provided by the treating professional.Alternatively, the user may reposition one or more teeth based on avisual appearance or based on rules and algorithms programmed into thecomputer. Once the user is satisfied, the final teeth arrangement isincorporated into a final digital data set (FDDS) (step 234).

The FDDS is used to generate appliances that move the teeth in aspecified sequence. First, the centers of each tooth model may bealigned using a number of methods. One method is a standard arch. Then,the teeth models are rotated until their roots are in the propervertical position. Next, the teeth models are rotated around theirvertical axis into the proper orientation. The teeth models are thenobserved from the side, and translated vertically into their propervertical position. Finally, the two arches are placed together, and theteeth models moved slightly to ensure that the upper and lower archesproperly mesh together. The meshing of the upper and lower archestogether is visualized using a collision detection process to highlightthe contacting points of the teeth.

In step 234, final positions for the upper and lower teeth in amasticatory system of a patient are determined by generating a computerrepresentation of the masticatory system. An occlusion of the upper andlower teeth is computed from the computer representation; and afunctional occlusion is computed based on interactions in the computerrepresentation of the masticatory system. The occlusion may bedetermined by generating a set of ideal models of the teeth. Each idealmodel in the set of ideal models is an abstract model of idealized teethplacement which is customized to the patient's teeth, as discussedbelow. After applying the ideal model to the computer representation,and the position of the teeth is optimized to fit the ideal model. Theideal model may be specified by one or more arch forms, or may bespecified using various features associated with the teeth.

Based on both the IDDS and the FDDS, a plurality of intermediate digitaldata sets (INTDDSs) are defined to correspond to incrementally adjustedappliances (step 236). Finally, a set of incremental position adjustmentappliances are produced based on the INTDDs and the FDDS (step 238).

Once the intermediate and final data sets have been created, theappliances may be fabricated as illustrated in FIG. 5. Commonfabrication methods employ a rapid prototyping device 501 such as astereolithography machine. A particularly suitable rapid prototypingmachine is Model SLA-250/50 available from 3D System, Valencia, Calif.The rapid prototyping machine 501 selectively hardens a liquid or othernon-hardened resin into a three-dimensional structure which can beseparated from the remaining non-hardened resin, washed, and used eitherdirectly as the appliance or indirectly as a mold for producing theappliance. The prototyping machine 501 receives the individual digitaldata sets and produces one structure corresponding to each of thedesired appliances. Generally, because the rapid prototyping machine 501may utilize a resin having non-optimum mechanical properties and whichmay not be generally acceptable for patient use, the prototyping machinetypically is used to produce molds which are, in effect, positive toothmodels of each successive stage of the treatment. After the positivemodels are prepared, a conventional pressure or vacuum molding machine551 is used to produce the appliances from a more suitable material,such as 0.03 inch thermal forming dental material, available fromTru-Tain Plastics, Rochester, Minnesota 55902. Suitable pressure moldingequipment is available under the trade name BIOSTAR from Great LakesOrthodontics, Ltd., Tonawanda, N.Y. 14150. The molding machine 551produces each of the appliances directly from the positive tooth modeland the desired material. Suitable vacuum molding machines are availablefrom Raintree Essix, Inc.

Due to regulatory requirements, each production step is recorded in adevice history database, which is a manufacturing database. In oneembodiment, the appliances are produced in batches, each having aplurality of appliances. Each batch is stored in a bin that is bar-codedand the progress of each bin is captured when the bin completes aparticular manufacturing step by scanning the bar-code associated withthe bin. In this way, entries are made in the device history database inaccordance with the bar-code after the completion of each manufacturingstep.

Eventually, the bins reach a laser marking station that marks eachaligner in the bin with a sequence identifier. In the marking station,the appliances are marked in some manner, typically by sequentialnumbering directly on the appliances or on tags, pouches, or other itemswhich are affixed to or which enclose each appliance, to indicate theirorder of use.

After production, the appliances can be supplied to the treatingprofessional all at one time. Optionally, written instructions mayaccompany the system which set forth that the patient is to wear theindividual appliances in the order marked on the appliances or elsewherein the packaging. Use of the appliances in such a manner will repositionthe patient's teeth progressively toward the final tooth arrangement.

Referring now to FIG. 6A, a process for sending messages generatedduring and after manufacturing is shown. The process 240 first affixesidentification information to one or more bins containing one or moreappliances (step 242). Next, each bin is moved through a series ofmanufacturing stations, and the movement of the bin to the nextmanufacturing station is captured (step 244). The bin history is storedin a device history database which is replicated for each appliance inthe bin (step 246). Next, the process 240 checks whether a manufacturingdeviation exists (step 248). If so, one or more manufacturing errormessages may be sent to manufacturing people (step 250) for rapidcorrective action if necessary. From step 248 or step 250, the process240 checks whether the manufacturing information is needed by a treatingprofessional (step 252). The access to this information may berestricted by using one or more predefined rules so that the treatingprofessional only has access to information necessary in making atreatment decision. If the information is needed by the treatingprofessional, the process 240 sends a message to the treatingprofessional (step 254). From step 252 or step 254, the process 240determines whether the information is needed by the patient (step 256).The information needed by the patient is typically near the end of themanufacturing process, for instance when the device is expected to beshipped. From step 256, if the information is needed by the patient, theprocess 240 sends a message to the patient (step 258). Next, the process240 checks whether all manufacturing operations have been completed(step 260). If not, the process 240 loops back to step 244 to continuecapturing the device manufacturing history.

FIG. 6B shows a second embodiment of a system for producing appliancesand scheduling appointments. First, one or more orders are received bythe system (step 262). The system in turn sends an electronic message tothe treating professional to confirm the order and to collect additionalinformation if necessary (step 264). Next, models are generated from thedata collected by the treating professional (step 266). The models areinspected by in-house treating professionals (step 268). The system alsosends an electronic message to the treating professional who sent theorder to either confirm that the model quality is acceptable and thatthe system will proceed with manufacturing. Alternatively, if the modelquality is not acceptable, the system sends an electronic message to theordering professional to request a reimpression of the patient (step270). From step 268, if the quality is acceptable, the system scans themodels, sets bite alignment and generates a treatment plan (step 272).Aligners are then produced (step 274) and electronic messages are sentto the treating professional and to the patient at appropriatemanufacturing steps to facilitate the scheduling of an appointmentbetween the professional and the patient (step 276). Finally, theappliances are packaged and shipped to the treating professional or thepatient (step 278).

FIGS. 7A-7B illustrate an exemplary usage of the system of FIG. 1. Aprospective patient uses a client computer 104 and visits the web siteon the dental server 106 (step 280). The client identifies a treatingprofessional and schedules an appointment with the treating professionalor a referring dentist can refer the client to the treating orthodontist(step 282). The referring dentist can visit the web site on the dentalserver 106 and uses one or more dental esthetic tools to show patientsthe potential benefits of anterior and posterior esthetic restorationsand, if the patient is interested, refers the patient to the treatingprofessional.

Once the patient requests treatment, the treating professional takesimpressions and a bite registration and sends the information to thesystem (step 284). At the company, another professional reviews therecords and decides to accept or decline the case. The impression andother patient data are then scanned (step 286). The data is then used togenerate a treatment plan and the treating professional is notified ofthe plan (step 288).

In one embodiment, the tooth models may be posted on a hypertexttransfer protocol (http) web site for limited access by thecorresponding patients and treating clinicians. Since realistic modelshave a large volume of data, the storage and transmission of the modelscan be expensive and time consuming. To reduce transmission problemsarising from the large size of the 3D model, in one embodiment, dataassociated with the model is compressed. The compression is done bymodeling the teeth meshes as a curve network before transmission to thetreating professional. Once the curve network is received, the 3D modelis reconstructed from the curve network for the treating professional toanalyze. More information on the compression is disclosed in aco-pending application having Ser. No. 09/506,419, entitled, “EfficientData Representation of Teeth Model”, and filed by Elena Pavlovskaia andHuafeng Wen on Feb. 17, 2000, the contents of which are herebyincorporated.

The treating professional can, at his or her convenience, check thesetup, and review the information sent in step 288 (step 290). Thetreating professionals can use a variety of tools to interpret patientinformation. For example, the treating professional can retrieve andanalyze patient information through a reconstructed 3D model of thepatient's teeth and other anatomical structures. The professional canview animations showing the progress of the treatment plan to help thetreating physician visualize the pace of treatment. Using these tools,the treating professional can easily and quickly view and/or edit thetreatment plan. If necessary, the treating professional can adjust oneor more teeth positions at various intermediate stages of treatment. Avariety of diagnostic decision-support capabilities such as automatedteeth collision detection can be used to aid the treating professionalin adjusting the teeth positions. When the treating professional arrivesat a prescription or other final designation, the treatment informationis automatically collected by the system over the Internet, thuseliminating the cost and delay associated with the traditional physicalshipping of patient information.

The patient can also review the treatment plan and visualize the resultusing 3D imaging tools described above (step 292). After review, thealigners are generated (step 294).

Referring now to FIG. 7B, during the fabrication of the aligners, thesystem of FIG. 7B monitors progress and informs doctors and patients ofthe manufacturing stage of the aligners (step 296). This may be done inaccordance with the process of FIG. 6 in one embodiment.

Next, the process of FIG. 7 determines whether the appliances aresufficiently close to a delivery point (step 298). If so, the processinvites the patient to schedule appointments electronically ortelephonically with a receptionist. This may be done automatically byhaving the patients send an email to a receptionist, or by having thepatient view an on-line calendar and selecting an available time toschedule an appointment (steps 300-302).

FIG. 8 is a simplified block diagram of a data processing system 300that may be used to develop orthodontic treatment plans. The dataprocessing system 300 typically includes at least one processor 302 thatcommunicates with a number of peripheral devices via bus subsystem 304.These peripheral devices typically include a storage subsystem 306(memory subsystem 308 and file storage subsystem 314), a set of userinterface input and output devices 318, and an interface to outsidenetworks 316, including the public switched telephone network. Thisinterface is shown schematically as “Modems and Network Interface” block316, and is coupled to corresponding interface devices in other dataprocessing systems via communication network interface 324. Dataprocessing system 300 could be a terminal or a low-end personal computeror a high-end personal computer, workstation or mainframe.

The user interface input devices typically include a keyboard and mayfurther include a pointing device and a scanner. The pointing device maybe an indirect pointing device such as a mouse, trackball, touchpad, orgraphics tablet, or a direct pointing device such as a touchscreenincorporated into the display, or a three dimensional pointing device,such as the gyroscopic pointing device described in U.S. Pat. No.5,440,326, other types of user interface input devices, such as voicerecognition systems, can also be used. User interface output devicestypically include a printer and a display subsystem, which includes adisplay controller and a display device coupled to the controller. Thedisplay device may be a cathode ray tube (CRT), a flat-panel device suchas a liquid crystal display (LCD), or a projection device. The displaysubsystem may also provide non-visual display such as audio output.

Storage subsystem 306 maintains the basic required programming and dataconstructs. The program modules discussed above are typically stored instorage subsystem 306. Storage subsystem 306 typically comprises memorysubsystem 308 and file storage subsystem 314.

Memory subsystem 308 typically includes a number of memories including amain random access memory (RAM) 310 for storage of instructions and dataduring program execution and a read only memory (ROM) 312 in which fixedinstructions are stored. In the case of Macintosh-compatible personalcomputers the ROM would include portions of the operating system; in thecase of IBM-compatible personal computers, this would include the BIOS(basic input/output system).

File storage subsystem 314 provides persistent (non-volatile) storagefor program and data files, and typically includes at least one harddisk drive and at least one floppy disk drive (with associated removablemedia). There may also be other devices such as a CD-ROM drive andoptical drives (all with their associated removable media).Additionally, the system may include drives of the type with removablemedia cartridges. The removable media cartridges may, for example behard disk cartridges, such as those marketed by Syquest and others, andflexible disk cartridges, such as those marketed by Iomega. One or moreof the drives may be located at a remote location, such as in a serveron a local area network or at a site on the Internet's World Wide Web.

In this context, the term “bus subsystem” is used generically so as toinclude any mechanism for letting the various components and subsystemscommunicate with each other as intended. With the exception of the inputdevices and the display, the other components need not be at the samephysical location. Thus, for example, portions of the file storagesystem could be connected via various local-area or wide-area networkmedia, including telephone lines. Similarly, the input devices anddisplay need not be at the same location as the processor, although itis anticipated that personal computers and workstations typically willbe used.

Bus subsystem 304 is shown schematically as a single bus, but a typicalsystem has a number of buses such as a local bus and one or moreexpansion buses (e.g., ADB, SCSI, ISA, EISA, MCA, NuBus, or PCI), aswell as serial and parallel ports. Network connections are usuallyestablished through a device such as a network adapter on one of theseexpansion buses or a modem on a serial port. The client computer may bea desktop system or a portable system.

Scanner 320 is responsible for scanning casts of the patient's teethobtained either from the patient or from an orthodontist and providingthe scanned digital data set information to data processing system 300for further processing. In a distributed environment, scanner 320 may belocated at a remote location and communicate scanned digital data setinformation to data processing system 300 via network interface 324.Fabrication machine 322 fabricates dental appliances based onintermediate and final data set information received from dataprocessing system 300. In a distributed environment, fabrication machine322 may be located at a remote location and receive data set informationfrom data processing system 300 via network interface 324.

The invention has been described in terms of particular embodiments.Other embodiments are within the scope of the following claims. Forexample, the three-dimensional scanning techniques described above maybe used to analyze material characteristics, such as shrinkage andexpansion, of the materials that form the tooth castings and thealigners. Also, the 3D tooth models and the graphical interfacedescribed above may be used to assist clinicians that treat patientswith conventional braces or other conventional orthodontic appliances,in which case the constraints applied to tooth movement would bemodified accordingly.

1. A method to support dental patient scheduling relating to one or moredental appliances, comprising: providing a server transmitting via anetwork information relating to a manufacturing stage of one or moredental appliances, the network coupled to one or more patient computers;accessing a database having information regarding manufacturing progressof the one or more dental appliances; determining whether themanufacturing progress has reached a predetermined stage; automaticallytransmitting manufacturing progress information to a patient computerover a wide area network in the absence of the patient prompting theserver to communicate the manufacturing progress information, thetransmitting occurring prior to completion of all manufacturingoperations for each of the appliances; and performing patient schedulingwhen one or more dental appliances reach a predetermined manufacturingprogress, patient scheduling occurring prior to completion of allmanufacturing operations for each of the appliances.
 2. The method ofclaim 1, wherein the server sends a message to a patient when theappliances are being marked.
 3. The method of claim 1, wherein theserver sends a message to the treating professional computer when theappliances reach one or more manufacturing stages.
 4. The method ofclaim 1, wherein the server sends an electronic mail message conveyinginformation relating to manufacturing progress.
 5. The method of claim1, wherein the server maintains an on-line calendar to scheduleappointments with a patient.
 6. The method of claim 1, wherein theserver invites a patient to log-on and schedule an appointment when theappliances reach a predetermined manufacturing stage.
 7. The method ofclaim 1, wherein the treating professionals include dentists ororthodontists.
 8. The method of claim 1, wherein the treatingprofessionals perform office management operations using the server. 9.A system adapted to support dental patient scheduling, the systemcomprising: a server that automatically transmits via a networkinformation relating to a manufacturing stage of one or more dentalappliances, the network coupled to one or more patient computers, theserver comprising a storage media having instructions that if executedcause the server to: access a database having information regardingmanufacturing progress of the one or more dental appliances; determinewhether the manufacturing progress has reached a predetermined stage;automatically transmit manufacturing progress information to a patientcomputer in the absence of the patient prompting the server to transmitthe manufacturing progress information, the transmitting occurring priorto completion of all manufacturing operations for each of theappliances; and perform patient scheduling when the one or more dentalappliances has reached the predetermined stage, patient schedulingoccurring prior to completion of all manufacturing operations for eachof the appliances.
 10. The system of claim 9, wherein the network isfurther coupled to one or more treating professional computers.
 11. Thesystem of claim 9, wherein the server sends a message to a patient whenthe appliances reach a predetermined manufacturing stage.
 12. The systemof claim 9, wherein the server sends a message to a patient when theappliances are being marked.
 13. The system of claim 9, wherein theserver sends a message to a treating professional when the appliancesreach one or more intermediate stages of manufacturing.
 14. The systemof claim 9, wherein the server sends an electronic mail message totransmit information relating to manufacturing progress.
 15. The systemof claim 9, wherein the server maintains calendar pages for the treatingprofessionals.
 16. The system of claim 9, wherein the server invites apatient to access an on-line calendar and schedule an appointment whenthe appliances reach the last stage of manufacturing.
 17. The system ofclaim 9, further comprising a network of treating professionals coupledto the network.
 18. The system of claim 9, wherein the server transmitsa request for intervention from manufacturing personnel when one or moremanufacturing stages fall behind schedule.
 19. The system of claim 18,wherein the server is configured to update the patient with informationrelating to a delay caused by manufacturing slippage.